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Fundamentals 1 > !! Chapter 35 Comfort and Pain Management > Flashcards

!! Chapter 35 Comfort and Pain Management Flashcards

1
Q

What are the 3 categories of pain?

A
  • Duration
  • localization/location
  • etiology
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2
Q

What are the 5 sources of pain?

A
  • nociceptive
  • cutaneous
  • somatic
  • visceral (splanchnic pain)
  • neuropathic
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3
Q

What is pain where there is actual or threatened damage to peripheral tissues and is representative of the normal pain process?

A

Nociceptive

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4
Q

What is pain where it involves the cutaneous layer, superficial skin, and subcutaneous tissue?

A

Cutaneous

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5
Q

What is deep tissue pain and where does it originate?

A

Somatic

-originates in ligaments, blood vessels, nerves, tendons, or bones

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6
Q

What is pain that originates in body organs such as the thorax, cranium, and abdomen?

A

Visceral (splanchnic pain)

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7
Q

What is pain from a lesion or disease of the CNS or PNS?

A

Neuropathic

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8
Q

A patient who has bone cancer is most likely experiencing which of the following types of pain?

A

Somatic

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9
Q

What are the 3 origins of pain?

A
  • Physical (cause of pain can be identified)
  • Psychogenic (cause of pain cannot be identified)
  • Referred (pain is perceived in an area distant from its point of origin)
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10
Q

What are the 4 parts to the pain process?

A
  • Transduction
  • Transmission
  • Perception of pain
  • Modulation
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11
Q

What stage of the pain process involves the activation of pain receptors, that involves conversion of painful stimuli into electrical impulses that travel from the periphery to the spinal cord at the dorsal horn.

A

Transduction

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12
Q

What stage of the pain process involves the conduction along pathways (A-delta and C-delta fibers). Pain sensations from the site of an injury or inflammation are conducted along pathways to the spinal cord and then on to higher centers.

A

Transmission

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13
Q

What stage of the pain process is when you are aware of the characteristics of pain?

A

Perception

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14
Q

What stage of the pain process involves the inhibition or modification of pain?

A

Modulation

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15
Q

What are receptors that recognize pain and send the signals to CNS?

A

Nociceptors (pain receptors)

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16
Q

What is a powerful vasodilator that increases capillary permeability and constricts smooth muscle. Also gets more blood flow to the area.

A

Bradykinin

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17
Q

What is an important hormone-like substance that sends additional pain stimuli to the CNS?

A

Prostaglandins

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18
Q

What sensitizes receptors on nerves to feel pain and also increases the rate of firing of nerves?

A

Substance P

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19
Q

What stimulates smooth muscle and inhibits gastric secretion and produces vasoconstrictions.

A

Serotonin

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20
Q

What are 4 types of nociceptors?

A
  • Bradykinin
  • Substance P
  • Serotonin
  • Prostaglandins
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21
Q

What is the gate control theory of pain?

A

Describes the transmission of painful stimuli and recognizes a relationship between pain and the projection of pain information to the brain (emotions).

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22
Q

What nerve fibers conduct excitatory pain stimuli toward the brain, exaggerating the effect of the arriving impulses through a positive feedback mechanism.

A

Small (C-delta fibers)

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23
Q

What nerve fibers appear to inhibit the transmission of pain impulses from the spinal cord to the brain through a negative feedback system.

A

Large (A-delta fibers)

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24
Q

The Gating mechanism:

A
  • determines the impulses that reach the brain.
  • Ex: If you can rub the injury site then you will stimulate the large nerve fibers and decrease the level of pain experienced by the person.
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25
Q

What nerve fibers convey diffuse, longer-lasting pain that is triggered by chemical stimuli or persistent mechanical or thermal stimuli?

A

Small (C-delta fibers)

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26
Q

What nerve fibers transmit acute, well-localized pain that is typically elicited by mechanical or thermal stimuli?

A

Large (A-delta fibers)

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27
Q

What are the 3 factors to perceiving pain?

A
  • pain threshold
  • adaptation
  • modulation of pain
28
Q

What is pain threshold?

A

The minimum intensity of a stimulus that is required to perceive as pain

29
Q

What are morphine-like chemical regulators in the spinal cord and brain that have an anaesthetic-like affect?

A

Neuromodulators

30
Q

How do neuromodulators produce their analgesic effects?

A

They bind to specific opioid receptor sites throughout the CNS, blocking the release or production of pain-transmitting substances.

31
Q

What are 3 types of opioid neuromodulators?

A
  • endorphins
  • dynorphins
  • enkephalins
32
Q

What neuromodulator is thought to reduce pain by inhibiting the release of substance P from the terminals of afferent neurons?

A

Enkephalins

33
Q

What neuromodulator is released when certain measures are used to relieve pain. They are powerful pain-blocking chemicals that have prolonged analgesic effects and produce euphoria.

A

Endorphins and dynorphins.

34
Q

What are the the peripheral somatosensory nerve fibers that transduce and encode noxious stimuli/pain?

A

Nociceptors

35
Q

What are the 3 common responses to pain?

A
  • physiologic (involuntary)
  • behavioral (voluntary)
  • affective (psychological)
36
Q

What are examples of physiologic responses?

A
  • increased BP, pulse, respirations, pupils dilate, etc.

- we can measure them!

37
Q

What are examples of behavioral responses?

A
  • moving away from pain, crying, grimacing, moaning, restlessness, etc.
  • any response to pain
38
Q

What are examples of affective responses?

A

-exaggerated weeping and restlessness, fear, anger, withdrawing, anxiety, depression, fatigue, hopelessness, etc.

39
Q

What is intractable pain?

A

Hard to deal with or control

40
Q

What are the 4 assessment parameters for pain?

A
  • psychological
  • emotional
  • sociologic
  • physiologic
41
Q

What are the 10 components of a pain assessment?

A
  • patients verbalization and description of pain
  • duration of pain
  • location of pain
  • quantity and intensity of pain
  • quality of pain
  • chronology of pain
  • aggravating/alleviating factors
  • physiologic indicators of pain
  • behavioral responses
  • effect of pain on activities and lifestyle
42
Q

What are the 6 basic methods of assessing pain?

A
  • patient self-report
  • Identify pathologic conditions or procedures that may be causing pain
  • report of family member/close person
  • nonverbal behaviors
  • physiologic measures
  • attempt an analgesic trial and monitor the results
43
Q

What does the FLACC pain scale stand for?

A
  • faces
  • legs
  • activity
  • cry
  • consolability
44
Q

What 4 factors are used to diagnose pain?

A
  • type of pain
  • etiologic factors
  • behavioral, physiologic, affective response
  • other factors affecting pain process
45
Q

What are the 7 nursing interventions for pain?

A
  • establish a trusting nurse-patient relationship
  • manipulating factors affecting pain experience
  • Initiating nonpharmacologic pain relief measures
  • manage pharmacologic interventions
  • review additional pain control measures
  • consider ethical and legal responsibility to relieve pain
  • teach patient about pain
46
Q

How can you manipulate pain experience factors?

A
  • remove or alter cause of pain
  • alter factors affecting pain tolerance
  • Initiate nonpharmacologic pain relief measures
47
Q

What are some examples of nonpharmacologic pain relief measures?

A 
Distraction 
Humor 
Music 
Imagery 
Relaxation
Cutaneous stimulation 
Acupuncture 
Hypnosis 
Biofeedback 
Therapeutic touch
Animal-facilitated therapy
48
Q

What is a pharmaceutical agent that relieves pain?

49
Q

What do analgesics do?

A

They function to reduce the person’s perception of pain and to alter the person’s responses to discomfort.

50
Q

What are the 3 general classes of drugs used for pain relief?

A

opioids
nonopioid analgesics
adjuvant analgesics

51
Q

What class of drugs are acetaminophen and NSAIDS?

A

nonopijoid analgesics

52
Q

What classifications of drugs are generally considered the major class of analgesics used in the management of moderate to severe pain because of their effectiveness?

A

opioid or narcotic analgesics

53
Q

What drugs are taken with opioids to increase the effect?

A

Adjuvant drugs

54
Q

What classifications of drugs are antidepressants, anticonvulsants, corticosteroids, and bisphosphonates?

A

Adjuvant drugs

55
Q

What are adjuvant drugs used to treat?

A
  • Acute pain resulting from surgery, burns, or trauma

- Neuropathic pain syndromes such as fibromyalgia, diabetic neuropathy, and postherpetic neuralgia

56
Q

What is the numeric sedation scale stages?

A

S: sleep, easy to arouse: no action necessary

1: awake and alert; no action necessary
2: occasionally drowsy, but easy to arouse; no action necessary
3: frequently drowsy, drifts off to sleep during conversation; reduce dosage
4: somnolent with minimal or no response to stimuli; discontinue opioid, consider use of naloxone

57
Q

What drug can you use if their is too much sedation?

58
Q

What are the 3 methods for administering analgesics?

A
  • patient-controlled analgesia
  • epidural analgesia
  • local anesthesia
59
Q

What is epidural analgesia?

A

The anesthesiologist usually inserts the catheter in the mid lumbar region into the epidural space between the walls of the vertebral canal and the dura mater or outermost connective tissue membrane surrounding the spinal cord.

60
Q

What is local anesthesia?

A

Anesthetic agents may be applied topically to the skin or mucous membranes or injected into the body to produce a temporary loss of sensation and motor and autonomic function in a localized area.

61
Q

How does the local anesthesia work?

A

The agents work by chemically blocking the nerve pathways involved in pain sensation and response, and are sometimes called nerve blocks.

62
Q

What is the time period for chronic pain?

63
Q

Disease is present, but the person does not experience pain

64
Q

The symptoms reappear

A

Exacerbation

65
Q

1 way to stop infection?

A

Hand washing

66
Q

Patient reports pain, but we don’t believe them so what do we do?

A

We have to believe them.

Fundamentals 1 (24 decks)

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